Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD)

  1. Conrado M. Fernández Rodriguez 1
  2. Rocío Aller de la Fuente 2
  3. Maria Luisa Gutierrez Garcia 1
  4. Javier Ampuero Herrojo 3
  5. Judith Gomez Camarero 4
  6. Rosa María Martín Mateos 5
  7. Diego Burgos Santamaría 5
  8. José Miguel Rosales 6
  9. Patricia Aspichueta Celaa 7
  10. Xabier Buque Garcia 7
  11. Mercedes Latorre 8
  12. Raúl J. Andrade Bellido 9
  13. Manuel Hernández Guerra 10
  14. Manuel Romero-Gómez 11
  1. 1 Hospital Universitario Fundación Alcorcón. Alcorcón, Madrid. Spain
  2. 2 Hospital Clinic. Valladolid, Spain
  3. 3 Hospital Universitario Virgen del Rocío. Sevilla, Spain
  4. 4 Hospital Universitario. Burgos, Spain
  5. 5 Hospital Universitario Ramón y Cajal. Madrid, Spain
  6. 6 Agencia Sanitaria Costa del Sol. Marbella, Málaga. Spain
  7. 7 Universidad del País Vasco (UPV/EHU). Bizkaia, Spain
  8. 8 Hospital General Universitario Consortium. Valencia, Spain
  9. 9 Hospital Universitario Virgen de la Victoria. Málaga, Spain
  10. 10 Hospital Universitario de Tenerife. Canary Islands, Spain
  11. 11 Universidad de Sevilla. Sevilla, Spain
Revista Española de Enfermedades Digestivas

ISSN: 2340-416 1130-0108

Year of publication: 2019

Volume: 111

Issue: 4

Pages: 264-269

Type: Article

DOI: 10.17235/REED.2019.5965/2018 DIALNET GOOGLE SCHOLAR

More publications in: Revista Española de Enfermedades Digestivas


Background: recent evidence suggests a causal link between serum uric acid and the metabolic syndrome, diabetes mellitus, arterial hypertension, and renal and cardiac disease. Uric acid is an endogenous danger signal and activator of the inflammasome, and has been independently associated with an increased risk of cirrhosis. Aim and methods: six hundred and thirty-four patients from the nation-wide HEPAMET registry with biopsy-proven NAFLD (53% NASH) were analyzed to determine whether hyperuricemia is related with advanced liver damage in patients with non-alcoholic fatty liver disease (NAFLD). Patients were divided into three groups according to the tertile levels of serum uric acid and gender. Results: the cohort was composed of 50% females, with a mean age of 49 years (range 19-80). Patients in the top third of serum uric acid levels were older (p = 0.017); they had a higher body mass index (p < 0.01), arterial blood pressure (p = 0.05), triglyceridemia (p = 0.012), serum creatinine (p < 0.001) and total cholesterol (p = 0.016) and lower HDL-cholesterol (p = 0.004). According to the univariate analysis, the variables associated with patients in the top third were more advanced steatosis (p = 0.02), liver fibrosis (F2-F4 vs F0-1; p = 0.011), NASH (p = 0.002) and NAS score (p = 0.05). According to the multivariate logistic regression analysis, the top third of uric acid level was independently associated with steatosis (adjusted hazard ratio 1.7; CI 95%: 1.05-2.8) and NASH (adjusted hazard ratio 1.8; CI 95%: 1.08-3.0) but not with advanced fibrosis (F2-F4) (adjusted hazard ratio 1.09; CI 95%: 0.63-1.87). Conclusion: higher levels of serum uric acid were independently associated with hepatocellular steatosis and NASH in a cohort of patients with NAFLD. Serum uric acid levels warrants further evaluation as a component of the current non-invasive NAFLD scores of histopathological damage